title: Promoting widespread, durable service quality via interlocking contingencies.
abstract: Technologies for promoting quality of organizational services to the developmentally disabled have been evolving over the past several decades. Feedback reinforcement and, often, goal-setting, powerful change tools, generally are incorporated within behavioral interventions. Despite their promise, wide-scale application of these strategies often is impeded by natural and informal organizational contingencies. In an attempt to combat such impediments, a structure of interlocking contingencies was designed to train and support managers' provision of effective feedback to their subordinates, peers, and superiors. The system included formal scheduling of feedback, reinforcement and goal setting in a way that attempted to (a) minimize financial costs, time and effort; (b) empower participants by involving them in designing the specifics of the system; and (c) promote momentum by encouraging dense schedules of feedback. Within a period of less than 6 months, supervisors, managers, and professional specialists conducted brief audits and delivered nearly 9,000 written feedback reports to workers serving 129 clients, with the result that staff-client interactions and client engagement levels increased substantially. Future research should replicate these methods under more rigorous experimental conditions and formally assess some of the system's spillover into realms such as gains in clients' skill levels, and staff and public acceptance.
authors.affiliation: University of Massachusetts, USA.
authors.forename: B
authors.initials: B
authors.lastname: Sulzer-Azaroff
authors.forename: M J
authors.initials: MJ
authors.lastname: Pollack
authors.forename: C
authors.initials: C
authors.lastname: Hamad
authors.forename: T
authors.initials: T
authors.lastname: Howley
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000628:therapy; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards*; D008875:Middle Aged; D010348:Patient Care Team; D011369:Professional-Patient Relations; D012720:Severity of Illness Index